Provider Demographics
NPI:1942289806
Name:IVES, MARTHA MUKA (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:MUKA
Last Name:IVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 WARD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1300
Mailing Address - Country:US
Mailing Address - Phone:303-422-6331
Mailing Address - Fax:303-422-6379
Practice Address - Street 1:5730 WARD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1300
Practice Address - Country:US
Practice Address - Phone:303-422-6331
Practice Address - Fax:303-422-6379
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0038825207R00000X
CO38825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04020541Medicaid
1215981634OtherGROUP NPI #
CO513142OtherMEDICARE GROUP NUMBER
CT080187783OtherRAILROAD MEDICRE
CO376028OtherCIGNA
CO84136530261OtherPACIFICARE PPO
CO8413653022AOtherPACIFICARE
CO39572544Medicaid
CO5646579OtherAETNA
CO841365302035OtherRKY MTN HMO
CORO103008OtherGROUP ANTHEM BCBS
COIV642883OtherANTHEM BCBS
1942289806OtherNPI #
CO8413653022AOtherPACIFICARE
CO513142OtherMEDICARE GROUP NUMBER
1942289806OtherNPI #
CO5646579OtherAETNA